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October 22, 2013

Congress Urges CMS Not to Cut Reimbursement for Vital Orthopaedic Procedures

Washington, DC—On October 15, 2013, seven members of Congress wrote Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner expressing their concerns about potential CMS cuts to Medicare reimbursement for total hip and knee replacement procedures in 2014. The letter, spearheaded by Congressman Tom Price, MD (R-GA) and Congressman Dutch Ruppersberger (D-MD), insisted that adequate public notice and comment opportunity were not provided, and as a result, patient care could be impacted. The letter urged CMS to carefully consider public comments before acting, including those of the doctors who perform these procedures.

“We believe doctors who perform these procedures should have an opportunity to examine CMS's recommendations and underlying data and offer their analysis and comments before any rate changes go into effect,” the letter states. “When considering rate changes, it is important to keep in mind that Medicare payments for hip and knee replacement procedures have not kept up with inflation. In real dollars, the payment rate has decreased 20% over the last 10 years.”

Joshua J. Jacobs, MD, President of the American Association of Orthopaedic Surgeons (AAOS) stressed the far-reaching implications these cuts would have for patient care. “Total hip and knee replacement surgeries are two of the most successful and life-enhancing surgical procedures. They relieve almost all pain for over 90 percent of patients who have the procedures, which allows patients to return to work and adds tremendous value to their lives,” Dr. Jacobs said. “To reduce Medicare physician payments for these procedures would severely limit beneficiary access to these important surgeries.”

The American Association of Hip and Knee Surgeons (AAHKS) President Thomas K. Fehring, MD, also expressed concern. “Medicare should not cut rates for hip and knee replacement surgery without giving doctors and their patients a full explanation, and without a fair comment opportunity,” Dr. Fehring stated. “Especially with the number of seniors who need this surgery and the aging population staying in the workforce longer, these procedures are vital for maintaining quality of life and will only continue to grow in importance.”

The letter was co-signed by Congressmen Vern Buchanan (R-FL); Marlin Stutzman (R-IN); Trey Radel (R-FL); Randy Neugebauer (R-TX) and Ron Kind (D-WI).

Read the October 15 letter here.


Elizabeth Fassbender
(202) 548-4143


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